| Joe O Othman Md Inc | |
|
Rr 2 Box 169 Greyrock Profess. Park Lewisburg WV 24901-9316 | |
| (304) 647-3040 | |
| (304) 647-3835 |
| Full Name | Joe O Othman Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | Rr 2 Box 169, Lewisburg, West Virginia |
| Authorized Official Name and Position | Joe O Othman (PRESIDENT) |
| Authorized Official Contact | 3046473040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joe O Othman Md Inc Rr 2 Box 169 Greyrock Profess. Park Lewisburg WV 24901-9316 Ph: (304) 647-3040 | Joe O Othman Md Inc Rr 2 Box 169 Greyrock Profess. Park Lewisburg WV 24901-9316 Ph: (304) 647-3040 |
| NPI Number | 1740305275 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 09/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740305275 | NPI | - | NPPES |
| 0089749000 | Medicaid | WV | |
| 9268691 | Other | WV | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 15411 (West Virginia) | Primary |
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